Medical involvement in crimes against humanity in Xinjiang, China
BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o44 (Published 17 January 2022) Cite this as: BMJ 2022;376:o44
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Editor,
As Stop Uyghur Genocide, the UK’s Uyghur-led, cross community campaign, we were extremely grateful for both your editorial (Medical involvement in crimes against humanity in Xinjiang, China BMJ 2022; 376) and the subsequent motion passed by the BMA’s Ruling Council taking substantive action to try and stop the medical abuse of Uyghurs and other Turkic groups in Northwest China.
We are now launching the ‘Healthcare Workers for Uyghurs’ campaign to enable healthcare workers, students and medical researchers, to support the actions outlined in both your editorial and in the Ruling Council’s motion.
In addition, we shall campaign for universities and learned societies to suspend all research, funding and educational links with the specialities responsible for the abuses in China - transplantation medicine, obstetrics and gynaecology and genomics. Others however have called for individual doctors and scientists to withdraw collaboration in all specialties. Our student organisation, Students for Uyghurs, which is looking to work with the BMA Medical Students Committee, has already issued Freedom of Information requests to Russell Group Universities to disclose all such links with Chinese institutions and entities in a wide variety of subjects, and has started to engage constructively with Deans and Vice-Chancellors.
All Healthcare Workers, including nurses and midwives, students and any medical researcher, from the UK or abroad, are invited to register their interest on our website (http://stopuyghurgenocide.uk/healthcare-workers-for-uyghurs/), where they can receive further information, sign up to our newsletter, share information and ideas, and they can follow us soon on Twitter. They will be able to take an active part in all aspects of this campaign, including supporting the long-standing work of ETAC (International Coalition to End Transplant Abuse in China) and DAFOH (Doctors Against Forced Organ Harvesting) to end forced organ harvesting.
Competing interests: No competing interests
Dear Editor
We agree with the recently editorial recently published in the BMJ which acknowledges the overwhelming evidence that crimes against humanity in China must involve the participation of medical professionals and which calls for the World Medical Association to consider expelling the Chinese Medical Association (1). We also note the accompanying Rapid Response which echoes the call for journals to consider refusing research submitted from China by implicated specialities and which also recommends suspending collaboration with these specialties and that universities and learned societies should suspend relationships with China linked to genocide and crimes against humanity (2).
We write to propose that, alongside these measures, there are actions that individuals can take. We recognise that the issues involved are complex and that people will have somewhat different views and hence that the responses of large organisations such as the World Medical Association, journals and universities may need careful consideration and will take some time to evolve. However, as individuals we can take a view of the situation as we see it and take action which fits with our personal ethical position. For ourselves, we have taken the view expressed in the editorial that the medical profession in China as a whole is complicit in these activities. We recognise that most doctors in China are not involved or probably even aware of them. We recognise that under China's repressive regime it would be impossible for individual doctors to protest or call for those involved to be professionally sanctioned. Therefore, with some regret, we feel that the only legitimate position for us to take is to break off all professional relationships with doctors and scientists in China. For us, this means that we will not engage in collaborative projects with them, we will not submit applications for funding jointly with them, we will not attend conferences in China and we will not support the publication of research carried out in China by providing peer review for submitted manuscripts.
We believe that if others take this position then it may in fact produce some practical benefits. Researchers in China need to publish in international journals in order for their careers to progress. If they find it more difficult to do this, and if they are informed that this is because of the involvement of their professions in these abuses, then it is possible that this will produce pressure for change within the Chinese system.
We have set up a web page where doctors and scientists who agree with this stance can publicly declare their support for it. We encourage anyone who agrees and who might be in a position to collaborate with doctors and scientists in China, whether this might be through submitting a joint grant application or simply being asked to provide peer review for a submitted manuscript, to consider adding their name: https://tinyurl.com/StopCollaborationWithChina
Prof David Curtis, MD PhD, FRCPsych
Prof Dr med Thomas G. Schulze, MD, FACNP, FAPPA
1. Sheather J, Tsang S, Greaves Z. Medical involvement in crimes against humanity in Xinjiang, China. BMJ. 2022 Jan 17;376:o44.
2. Stone SP, Sharif A, Hughes S. Rapid response re: Medical involvement in crimes against humanity in Xinjiang, China - time to suspend medical collaborations with complicit specialities. BMJ. 2022;376.
Competing interests: No competing interests
Dear Editor,
As a coalition of medical, legal and human rights NGOs seeking to stop China’s medical abuse of Uyghurs and other minorities, we were encouraged to read last week’s editorial (Medical involvement in crimes against humanity in Xinjiang, China BMJ 2022; 376.) calling for the expulsion of the Chinese Medical Association by the World Medical Association, and for the international medical community to petition politicians to lobby for an independent international investigation by a reputable authority. We also note that last week the BMA’s Ruling Council passed a motion not only endorsing the actions recommended in the editorial but empowering the BMA ‘to work with journals to consider refusing research submitted by those specialties from China implicated in the atrocities.’ (1)
We recommend that in addition an additional policy should be pursued in parallel with those above - suspending medical collaborations with China’s specialists in transplant medicine and surgery, obstetrics, family planning and genomics. Universities, and both national and international Learned Societies, should transparently review their research, educational and financial relationships with China, and suspend those with links to Genocide and Crimes Against Humanity.
The medical community has in the past been hesitant to take such actions against doctors who have acted under the direction of a State’s political or social policies. The nature of these medical abuses would have, however, required the participation of Chinese doctors in both policy, planning and implementation. It is time for the international medical community to play their role in increasing pressure on China to stop such medical abuse.
The China Tribunal (2) investigating forced organ harvesting concluded beyond reasonable doubt that forced organ harvesting from prisoners of conscience is taking place in China, and “Any who interact in any substantial way with the PRC, including Doctors and medical institutions… should now recognise that they are interacting with a criminal state.” A failure to undertake such a review and stop collaborating in work supporting genocide and crimes against humanity may place the above medical bodies and individual medical practitioners in breach of their ethical standards and even result in them being complicit in these crimes.
The Chinese Medical Association describes itself as ‘the largest and oldest non-governmental medical organization in China,’ ‘an important social force in the development of medical science and technology, and a linkage (sic) between government and the medical professionals’ and as ‘playing a leading and active role in the nation's medical education, training and professional exchanges.’
Medical experts, lawyers and researchers from our organisations would be interested in a head-to- head debate with the CMA on the evidence at hand regarding the current medical crimes against Uyghurs and other minorities in China, and on the actions the editorial and ourselves recommend be taken to bring these to an end.
1. https://www.bma.org.uk/bma-media-centre/bma-condemns-appalling-medical-i...
2.China Tribunal. Independent Tribunal into Forced Organ Harvesting https://chinatribunal.com/final-judgment
Yours sincerely,
Sheldon Stone
Adnan Sharif
Susie Hughes
Competing interests: No competing interests
Dear Editor
I am sure the investigators must have had access to the doctors involved in these activities and what they had to say in their defence. Because if this was not the case then one cannot be sure that the Doctors involved in such crimes were not under threat to themselves or their families to do such acts. This is a classical case of doctors being made scapegoats when you can do nothing to the real perpetrators. We should condemn the crimes happening anywhere in the world but very skeptical about smearing anyone or any profession without obtaining knowledge about their version of the subject.
Regards
Competing interests: No competing interests
Dear Editor
Next week Holocaust Memorial Day is coming (27 January 2022). The theme this year is consideration of "One Day", when humanity can hope in a future with no genocide ( https://www.hmd.org.uk/what-is-holocaust-memorial-day/this-years-theme/ ). The persecution of the Uyghur ethnic minority by the Chinese Communist Party has co-opted doctors ( see https://www.bmj.com/content/375/bmj.n3124/rr ) but persecution can take different forms in different countries.
Here in the UK, the recent Police, Crime, Sentencing and Courts Bill could have had a crushing impact on mobile populations, such as the Gypsy & Traveller community. Thankfully, popular protest and vigilance in the amending chamber ( the House of Lords ) may have prevented that ethnic discrimination, There is a lesson in the Greek myth of Argus, who had 100 eyes. He could maintain his vigilance, at all times !
Competing interests: No competing interests
Xinjiang-Related Allegations in a BMJ Article Ignoring facts and Seriously Illegal
Dear Editor
Julian Sheather et al. published an article titled “Medical involvement in crimes against humanity in Xinjiang, China” in the BMJ, arguing that Chinese medical professionals participated in the so-called “crimes against humanity” in Xinjiang, and the international medical community must act on the findings of the so-called “tribunal”, including reconsidering the membership of the Chinese Medical Association in the World Medical Association [1]. This is the wrongful political maneuver of the authors that disregard facts and abuse legal concepts in an academic journal. This is slander against Chinese medical professionals and disrespect for the international medical professional community.
First of all, there is no legal basis for the establishment of the so-called “tribunal” on which the authors base their article. In December 1948, the UN General Assembly adopted the Convention on the Prevention and Punishment of the Crime of Genocide (Convention) [2] which defined the crime of genocide for the first time and obliged States to prevent and punish acts of genocide. The Convention requires the trials to be held by courts of the territory where the crime took place, or by an international tribunal as may have jurisdiction with respect to those contracting parties which shall have accepted its jurisdiction. Other than that, no entity can arrogate to itself the power to sit in judgment of another State and to declare that another State has committed genocide. The so-called “tribunal” chaired by Sir Geoffrey Nice QC is an informal organization set up by the “World Uyghur Council” and other western anti-China actors with no legal function but obvious political prejudice and appeal and is seriously misleading. It is very inappropriate for an academic journal to discuss issues on the basis of such a “tribunal” and its so-called “judgement”. Such an act seriously affects the reputation and legal rights and interests of the relevant State and its citizens.
Secondly, under the Convention, customary international law, and relevant case law, [3] a finding of genocide must result from the application of authoritative, stern, and inflexible legal rules. It must survive strict scrutiny of facts and withstand the test of time.
The so-called “judgement” made on the basis of a patchwork of “evidence” and a smattering of law is completely a “self-directed and acted” farce. In terms of evidence, the so-called “tribunal” has admitted a number of “witness evidence”, “expert evidence” and “factual evidence from various reports”. A witness’ evidence, in itself, usually cannot be used as the main and direct basis for the determination of relevant facts under international law. [4] Even if a witness statement is admissible as evidence, the subject, time and place of the statement, and the relationship between the subject of the statement and the person against whom it was made are factors that the courts and tribunals must consider carefully. [5] Not only is the source of the “witness statement” in the so-called “judgement” unknown, but the “tribunal” also stated that it had noted that “on occasion not every word was considered accurate” [6] and that “the allegations themselves and much of the evidence provided by witnesses came from people predisposed against the PRC”. [7] In these circumstances, the “tribunal” still considered such witness statements to be reliable, and made a conclusion that was inconsistent with the spirit of law, contrary to the principle of justice and completely unconvincing. In addition, the so-called “experts” and “witnesses” of this “tribunal” include the Australian Strategic Policy Institute, Adrian Zenz and other institutions and persons that have long spread political lies related to Xinjiang. The entities concerned are highly political actors, rather than reliable professionals.
As far as the law is concerned, the so-called “tribunal” confused the different crimes of international law, such as “crimes against humanity” and “genocide” and had a poor understanding of what constituted the relevant crimes. The crime of genocide is very strictly defined in international law. In terms of the act, the crime of genocide must be grounded on the proof that there was the commitment of specific acts provided by the Convention. In terms of intent, it must be proven that there was a specific intent to destroy “in whole or in part” a particular group. This is a critical element for a finding of genocide. [8] Although the authors of the article are not lawyers, after realizing the sources of such “evidence” and “facts”, as “reasonable persons”, they should be able to see the nature of the performance of the so-called “tribunal”.
Thirdly, the allegations of the authors against Chinese medical professionals are untrue. There is no such thing as “genocide” or “crimes against humanity” in China, let alone the participation of medical professionals in such crimes. In fact, compared with the data from the sixth national census in 2010, the data from the seventh national census in 2020 show that the Uyghur population in Xinjiang increased by 1.623 million, up by 16.2 percent. [9]
We are supposed to be more aware that all issues should be addressed in an objective and facts-based fashion. We must never promote actions that fundamentally hinder the solidarity and development of the international medical community and must never distort and act against the purposes of the World Medical Association just because of some groundless data or reports with ulterior motives. Respect for facts and laws is supposed to be the basic standpoint and attitude of every organization and individual.
LIU Huawen, Deputy Director and Professor of international human rights law, Executive Director of Center for Human Rights Studies [1]
HE Tiantian, Associate Professor of international law [2]
1 Institute of International Law, Chinese Academy of Social Sciences (CASS), Center for Human Rights Studies, CASS, Beijing, China
2 Institute of International Law, CASS, Beijing, China
1 Sheather J, Tsang S, Greaves Z. Medical involvement in crimes against humanity in Xinjiang, China. BMJ 2022;376:o44 http://dx.doi.org/10.1136/bmj.o44.
2 Convention on the Prevention and Punishment of the Crime of Genocide, 9 December 1948, United Nations, Treaty Series, vol. 78, p. 277.
3 Application of the Convention on the Prevention and Punishment of the Crime of Genocide (Bosnia and Herzegovina v. Serbia and Montenegro), Judgment, I.C.J. Reports 2007, p. 43, at paras. 209-210.
4 Military and Paramilitary Activities in and against Nicaragua (Nicaragua v. United States of America), Merits, Judgment, I.C.J. Reports 1986, p.14, at para.68.
5 Territorial and Maritime Dispute between Nicaragua and Honduras in the Caribbean Sea (Nicaragua v. Honduras), Judgment, I.C.J. Reports 2007, p.659, at para.244.
6 Uyghur Tribunal, Uyghur tribunal judgment, at para.27.
7 Uyghur Tribunal, Uyghur tribunal judgment, at para.16.
8 See William A. Schabas OC MRIA, Genocide in International Law: The Crimes of Crimes (Cambridge University Press, 2nd edn, 2009).
9 “Main Data of Xinjiang Uygur Autonomous Region from the Seventh National Population Census”, Statistic Bureau of Xinjiang Uygur Autonomous Region, https://tjj.xinjiang.gov.cn/tjj/tjgn/202106/e3605637963f4f7280654a6f07af... (last visited April 6, 2022).
Competing interests: No competing interests